Provider Demographics
NPI:1053978684
Name:PRINDIVILLE, VICTORIA A (LPC, NCC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:PRINDIVILLE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1626
Mailing Address - Country:US
Mailing Address - Phone:630-664-8252
Mailing Address - Fax:
Practice Address - Street 1:25 E RIVER RD
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1626
Practice Address - Country:US
Practice Address - Phone:630-664-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00663000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health